Evaluation of some cellular biomarker proteins, oxidative stress and clinical indices as results of laparoscopic appendectomy for perforated appendicitis in children

Abstract

Laparoscopic appendectomy for perforated appendicitis in children has the advantages of quick recovery, little influence of inflammatory and oxidative stress and low infection rate. Altogether 115 children with perforated appendicitis treated in our hospital from June 2018 to August 2019 were selected and divided into two groups according to different treatment methods. Laparoscopic appendectomy was used as the research group (RG) (67 cases) and open appendectomy (48 cases) as the control group (CG). The clinical indexes (operation time, intraoperative blood loss, ambulation time, incision length, postoperative exhaust time and length of stay) of the two groups were observed. The levels of C- reactive protein (CRP), procalcitonin (PCT), interleukin -6 (IL-6) and tumor necrosis factor-α (TNF-α) before and after treatment were detected by enzyme-linked immunosorbent assay (ELISA). The levels of oxidative stress factors (superoxide dismutase (SOD), malondialdehyde (MDA)) and the incidence of postoperative incision infection were observed in the two groups. A visual analogue scale (VAS) score was used to evaluate the postoperative pain in children. Logistic regression analysis was used to analyze the risk factors of postoperative incision infection in children. The improvement degree of clinical indicators in RG was significantly better than that in CG. The expression levels of CRP, PCT, IL-6 and TNF-α in RG were significantly lower than those in CG. The expression levels of SOD and MDA in RG were significantly better than those in CG. The postoperative incision infection rate in RG was significantly lower than that in CG. The postoperative VAS score in RG was significantly lower than that in CG. Logistic regression analysis results showed that the risk of incision infection was increased in children with operation time over 1h, incision length >3cm, high CRP, high PCT, high IL-6, high TNF-α, high SOD and low MDA. Laparoscopic appendectomy for perforated appendicitis in children can effectively reduce intraoperative hemorrhage, postoperative pain, and the damage to the body of children, and can also reduce oxidative stress and inflammatory reaction in children.

Oxidative Stress and Inflammation Biomarkers in Postoperative Pain Modulation in Surgically Treated Patients with Laryngeal Cancer—Pilot Study

“…This study also highlighted a significant positive correlation between SOD and GPX in the postoperative period and found significant negative correlation between SOD and the subjectively assessed level of postoperative pain. In a study conducted by Liu et al in the pediatric population undergoing appendectomy, plasma SOD concentrations were observed to be elevated in the postoperative period compared to a control non-operated group [9]. Salehi et al found elevated SOD and GPX levels in patients after colorectal adenocarcinoma surgery [42].…”

“…Surgical trauma can cause significant physiological stress in the body. Mechanical tissue damage results in activation of complement, polymorphonuclears, and macrophages, causing increased release of ROS and oxidative damage in the postoperative course [8,9]. Hypoxia also increases the release of endothelin-1 and the scavenging of NO, producing vasoconstriction, further hypoxia, ischemia, and subsequent release of tumor necrosis factor-α (TNFα), which serves to augment the stress response [10].…”

“…Similarly, release of ROS due to tissue damage and inflammation might increase the stimulation of sensory neurons that play a role in the transmission of pain [12,13]. Due to this type of connection, systemic markers of oxidative stress such as MDA, SOD, and GPX could serve as new biomarkers of pain intensity and postoperative pain management in surgically treated patients [8][9][10][11].…”

Post-Traumatic Stress Response and Appendicitis in Children—Clinical Usefulness of Selected Biomarkers

“…The significant increases in IL-6 levels observed after surgical procedures confirm what has been reported in the literature. Chinese authors have described a significant increase in IL-6 after appendectomy procedures in a group of children operated on, regardless of the chosen method, indicating the additional advantages of decreased injury and lower inflammation after laparoscopic procedures [32]. On the other hand, Turkish researches have not demonstrated an increase in IL-6 after laparoscopic procedures, however, after conventional appendectomy they did observe significantly higher levels of this marker compared to preoperative concentrations [33].…”

Diagnostic value of abdominal ultrasound in patients with acute appendicitis and analysis of the expression of related inflammatory factors.

“…Appendicitis is usually caused by a bacterial infection in the lumen of the appendix, especially when the appendix is blocked; bacteria can multiply inside the appendix, causing inflammation and infection [1][2][3][4] . If left untreated, the inflammation may spread to tissues and organs around the appendix, leading to peritonitis and other infections 5 .…”